Objective:To explore the treatment and effect of ABO-different orthotopic liver transplantation(OLT).Methods:Fifteen cases of ABO-different OLT were analyzed retrospectively.Six cases of ABO-different but compatible OLT were treated routinely.In 9 cases of ABO-incompatible OLT,plasma exchange was done in 1 case before operation,splenectomy was done in 5 cases during operation,the hepatic artery and biliary duct anastomosis were performed by the microvascular technique.The immuno suppressive protocol included a quadruple drug therapy,and anticoagulant therapy were performed postoperation.Results:No complications were found in 6 cases of ABO-different but compatible OLT.Of the 9 cases of ABO-incompatible OLT,4 patients recovered smoothly without complications.Postoperative complications included acute rejection in 3 patients,biliary nonanastomotic stricture in 4 patients,and 3 cases died.Conclusion:The effect of ABO-different but compatible OLT is good.ABO-incompatible OLT can be used when the graft is scarce,but we should manage to decrease the complications.

Objective To explore the clinical experience of liver retransplantation in management of biliary complications after liver transplantation.Methods The clinical data of patients receiving liver transplantion in our department between April 2002 and Aug. 2004 were retrospectively analyzed, including 5 patients being subjected to liver retransplantation because of serious biliary complication.Results Three patients were cured with the survival time being 5 months, 6 months and 8 months respectively. Two patients died at 8th and 43rd day: one died of liver non-function combining with lung infection and heart failure, and another died of renal failure. Complications included liver absess, biliary infection, wound infection, hydrops abdominis and lung infection.Conclusions Liver retransplantation is an effective treatment for serious biliary complications after liver transplantation. Surgical procedure, indication, operative opportunity, perioperative monitoring and so on contribute to the increase of the survival rate of the patients receiving liver retransplantation.

Objective To evaluate the effectiveness of scanning with labeled autologous leukocytes for the detection of abdominal inflammation in equivocal patients. Methods From July 1998 to April 2000 sixteen patients with equivocal abdominal inflammation were recruited into this study. ResultsThere were 10 cases with positive scanning. The diagnosis of intraabdominal infection was consequently confirned by laparotomy and or good response to antibiotic therapy.The 6 cases with negative result were eventualy proven to have no intraabdominal infection. The average radioactivity of imaging and paired non imaging district was determined ( P

Objective To investigate the effects and mechanisms of the CXCR3-inhibitor genistein on the acute rejection reaction of pancreas transplantation in a rat model. Methods Three groups of rats underwent pancreas transplantation, group one: the syngeneic transplantation group; group two: heterogous transplantation group without genistein-treatment; and group three: genistein-treatment (10 mg/kg,i. p.×7d) transplantation group. The grafts of three groups were harvested at day 7 after operation for histopathology and immunohistochemistry analysis of CXCR3, the serum levels of IFN-γ, IL-2 were examined by ELISA. Results There was no acute rejection reaction of pancreas transplantation in group one and no expression of CXCR3 ,the serum levels of IFN-γ,IL-2 were (2.76±0.66) pg/ml and (11.83±1.86) pg/ml. In group two, there was significant acute rejection reaction and strong expression of CXCR3, the serum levels of IFN-γ, IL-2 were (32.64±2.52) pg/ml and (29.59±1.71 ) pg/ml, which were significantly higher than those in group one (P<0.05). Compared with group two, the damages of graft tissue in genistein-treatment group alleviated and the lymphocytes infiltration decreased, the expression of CXCR3 was weakly positive, the serum levels of IFN-γ, IL-2 were (15.94±1.95) pg/ml and (22.62±1.76) pg/ml, which were significantly lower than those in group two(P<0.05), but was higher than those in group one (P<0.05). Conclusions Genistein could mitigate the acute rejection of pancreas transplantation effectively through inhibiting CXCR3 expression.

Objective To investigate the impacts of preoperative portal vein thrombosis (PVT) on intraoperative or postoperative parameters in patients receiving orthotopic liver transplantation (OLT). Methods The clinical data of 836 patients undergoing OLT in our hospital from February 2002 to February 2007 were retrospectively analyzed. Of the 836 patients, 71 had preoperative PVT (PVT group) and the other 765 had not (control group). Intraoperative patameters (operative dura-tion, anhepatic phase duration, blood transfusion volume) and postoperative parameters (ICU stay and hospitalization time, portal rethrombosis posttransplantation, graft function, portal vein flow, death rate in perioperation and 1-, 3-, 5-year survival rate) were compared between the 2 groups. Results The operative duration and anheptic phase duration were significantly higher in the PVT group than in the control (792. 47±62. 29 min vs 516. 18±86. 30 min, P<0. 01, 77. 53±24. 76 min vs 48. 55±31. 20 min, P<0. 05). Perioperative blood transfusion volume, average ICU stay and hospitalization duration were not significantly different between the 2 groups. The incidence of postoperative portal rethrombosis was remarkably higher in PVT group than in the control (9. 86% vs 1. 44% , P<0. 01).No significant differences in the graft function and portal vein flow (PVF) between the 2 groups except for a higher PVF in the PVT group on the 90th d(41. 43±17. 19 vs 19. 85±11. 39, P<0. 05). We noticed slightly higher death rate in perioperative and lower 1-, 3-, 5-year survival rate in the PVT group. Conclusion Preoperative PVT can gain the same favorable outcomes as in those without PVT in spite of readily intraoperative complex.

Objective To evaluate the influence of L-ornithine-L-aspartate (LOLA) on model for end stage liver disease(MELD) score and liver function of patients with chronic liver failure (CLF). Methods Sixty patients consecutively admitted to our hospital from May, 2002 and November, 2008 were enrolled into the study and randomly divided into low dose group (LD group, LOLA:10 g/d) and high dose group (HD group, LOLA :20 g/d)After treatment of LOLA, the clinical data ( serum NH3 , MELD score and liver function ) were compared between the two groups. Results Compared to serum NH3 level before treatment, serum NH3 decreased ( 62.59 + 27.87 )μmoL/L in the HD group and (49.36 + 27.34 ) μmol/L in the LD group, and both decreasements were statistical significant (Ps ＜ 0. 05 ). Compared to MELD before treatment, MELD score decreased ( 8.38 ± 2. 24 ) and ( 14.57 + 7.68), respectively ( Ps ＜ 0.05 ). Compared to LD group, all indices of liver function in the HD group improved more compared to those of the LD group ( Ps ＜ 0.05 ). Conclusions LOLA could significantly decrease serum NH3 and MELD score and improve liver function in CLF patients.

ObjectiveTo investigate the clinical efficacy of vastus medialisoblique enhancement plus electroacupuncture intervention in treating patellar chondromalacia.MethodFifty-two patients meeting the inclusion criteria were randomly allocated to a treatment group of 32 cases and a control group of 20 cases. The treatmentgroup received vastus medialis oblique enhancement plus electroacupuncture intervention and the control group, electroacupuncture intervention alone. Both groups were treated once daily, 10 times as a course, for four consecutive courses. The Visual Analogue Scale (VAS) score was counted in the two groups before and after treatment. The clinical therapeutic effects were evaluated in the two groups.ResultThe VAS score improved significantly in both groups of patients after treatment compared with before(P<0.05). It improved significantly more in the treatment group than in the control group (P<0.05). The cure rate and the total efficacy rate were 37.5% and 96.9%, respectively, in the treatment group, which were higher than a cure rate of 20.0% and a total efficacy rate of 75.0% in the control group, respectively. ConclusionVastus medialis oblique enhancement plus electroacupuncture intervention can improve the clinical symptom of pain more markedly and heighten the clinical therapeutic effect in patients with patellar chondromalacia. Its effect is better than that of electroacupuncture intervention alone.

Objective To explore the treatment of ABO-incompatible orthotopic liver transplantation. Methods Nine cases of ABO-incompatible liver transplantation performed in our hospital were analyzed retrospectively. Plasma exchange was done before the operation in 1 case. Hepatic artery and biliary duct anastomosis were performed by the microvascular technique. Splenectomy was done during operation in 5 cases. The immunosuppressive protocol included a quadruple drug therapy. Blood oxygen saturation was maintained above 95% and anticoagulant therapy was performed after operation.Results Four patients recovered smoothly without complications. Postoperative complications included acute rejection in 3 patients and biliary nonanastomotic stricture in 4. Three patients died. Conclusion ABO-incompatible orthotopic liver transplantation can be used when the graft is scarce, and should manage to decrease the complications.

Objective:To investigate the management in patients with complete portal vein (PV) and superior mesenteric vein (SMV) thrombosis during liver transplantation (LT). Methods:Seven patients with complete PV and SMV thrombosis undergone LT, The reconstruction of PV were the anastomosis PV to varicose coronary vein in 3 cases, PV to varicose vein near hilus of spleen in 2 case, PV to varicose vein in front of common bile duct in 1 case, PV to varicose right gastro-epiploic vein in 1 case. Results:All patients undergone successful LT. One case died 7 days after the transplantation of multi-organic nonfunction, but the PV was patent. One case was found stenosis at the anastomosis 6 months after LT, and he was cured by percutaneous transhepatic portography and stent placement. Other patients were followed-up12~22 months, the PVs were patent, and had sufficient blood supply, and they have normal liver and kidney functions now. Conclusion :The anastomosis between graft portal vein and the splanchnic varicose vein may be a applicable choice for the patients with complete PV and SMV thrombosis during LT.

Objective:To investigate the role of interstitial cells of cajal(ICC) in the pathogenesis of HD through observing the distribution of the cells in normal colon and HD's different segments.Methods:The aganglionic、transitional and dilated segments were collected in operations from 25 children with Hirschsprung’s disease.Another 6 normal segmengts were also collected.Each sections was stained by c-Kit immunohistochemistry.The distribution of the interstitial cells of Cajal was observed by light microscope.Results:The ICC in aganglionic segments of colon from Hirchsprung’s disease were decreased significantly and statistically than that in dilated and normal colon.Moreover,whole mount preparations showed that,not only the number of ICC-IM was decreased down,but also the branches of ICC-IM and the cellular network were also broken down.Conclusion:The pathogenesis of HD is related to the abnormal distribution of ICC,which lead to or aggravate the bowel spasm in HD.